The use of positive behaviour support plans in mental health inpatient care: A mixed methods study

Louise L. Clark, Fiorinta Lekkai, Anthony Murphy, Luisa Perrino, Savin Bapir-Tardy, Elizabeth Alexandra Barley

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
414 Downloads (Pure)


3.1 Introduction
An international drive is to minimize restrictive practices in mental health care. Positive behaviour support plans (PBSPs) help staff prevent behaviour which would require restrictive intervention. Originating in learning disability services, data within mental health care are limited.

3.2 Aims
To evaluate PBSPs within a mental health inpatient service; understand mental health nurses' and relatives' attitudes to them; and understand the barriers and facilitators for their use in routine mental health care.

3.3 Methods
Mixed methods—quality ratings and interviews with relatives and nurses.

3.4 Results
Positive behaviour support plans were poorly implemented. Relatives and nurses valued the potential of PBSPs to facilitate holistic care, though no relative had contributed to one and not every eligible patient had one. Barriers to their use included confusion around positive behaviour support, including how, when and for whom PBSPs should be used, and difficulties describing the function of a behaviour.

3.5 Discussion
The potential of PBSPs to improve mental health care is recognized. However, there are barriers to their use which should be addressed to ensure that PBSPs have been properly implemented before their impact on patient care can be assessed.

3.6 Implications for practice
Mental health professionals implementing PBSPs should engage with relatives and patients, gain organizational commitment and ensure that those involved understand fully the positive behaviour support approach.
Original languageEnglish
Pages (from-to)140-150
Number of pages11
JournalJournal of Psychiatric and Mental Health Nursing
Issue number2
Publication statusPublished - 20 Sept 2019


  • aggression
  • mental health nursing
  • positive behaviour support
  • restrictive practices
  • violence


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